Home care policy and regulation has not kept pace with the growing demand for services and the increased overall visibility of the sector.
For policymakers looking to address industry challenges and ultimately increase access to home care, six policy priorities need to be considered, according to a new report released Wednesday by the Home Care Association. of America (HCAOA).
“With Medicare population growth expected to double from 40 million to 80 million adults by 2040, we need to start now to close the gaps in care for older Americans,” said Vicki Hoak, CEO. of HCAOA, in a statement.
Indeed, there are demographic shifts in the United States that indicate the growing need for aged care services. About 81 million people in the United States will be 65 years older by 2040, compared to 77 million under the age of 18.
Additionally, someone who turns 65 today has nearly a 70 percent chance of needing long-term care and support, according to the US Department of Health and Human Services (HHS).
When it comes to the type of care seniors prefer, services that allow them to age in place for as long as possible are extremely popular.
In order to strengthen the home care sector and, in turn, meet the growing demand for care, the HCAOA urges policy makers to prioritize the establishment of an industry-coordinated set of standards for federal and state levels.
“Without standards on caregiver training, inconsistencies in the types, levels and quality of services can hamper the industry’s ability to define itself as a trusted and sought-after service provider,” HCAOA writes in the report. “It also has implications for the safety of home care clients.”
As part of its call for national standards of care for agencies, HCAOA is also promoting state licensing. Currently, only 30 states require agencies to obtain a personal care license, and licenses vary from state to state.
According to the report, another priority of home care policy is the collection, evaluation and use of data to validate the value of home care.
“[Sparse] research on the impact of home care as a whole has hindered the advancement of home care in securing a place in this country’s health care system,” the organization wrote. “Real data – rigorously collected and analyzed – which in turn can demonstrate cost savings will be essential if policy change is to take place. Therefore, investments must be made to collect, analyze and use data through large-scale studies.
HCAOA also urges policymakers to fully integrate home care into the health care system.
“While federal policy has progressively recognized the value of home care, this attention has failed to provide home care as a right under Medicaid or more comprehensive coverage under Medicare” , the organization wrote. “Home care must be part of the policy dialogue as health systems adapt to a more values-based approach to health care.
As staffing shortages continue to plague the home care sector, it will also be important for policymakers to focus on building the care workforce. These include changing the perception of the caring profession, raising training and education standards, and supporting and rewarding carers.
Funding for home care should also be a priority for policy makers, according to the report.
“To help people prepare for their future health and care needs, both the public and private sectors should continue to promote savings mechanisms that include financing professional home care,” the HCAOA wrote.
Finally, the issue of immigration should be a priority area.
Overall, immigrants make up the bulk of the home care workforce — nearly one-third.
“The U.S. immigration system lacks temporary visa categories for nonimmigrants and immigrants for low-skilled home health care workers,” the National Immigration Forum said in the report. “Therefore, it is essential to enact immigration reforms that take into account the needs of the home health care sector.”